Helicobacter Pylori Infection in Patients With Neurological Symptoms of Vitamin B12 Deficiency

Abstract

Background: Vitamin B12 is essential for DNA synthesis, formation of myelin sheaths, neurotransmitter synthesis, and erythropoiesis. Insufficient intake or disrupted absorption of vitamin B12 results in deficiency. Clinical manifestations of vitamin B12 deficiency include hematologic and neuropsychiatric disorders. Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in humans. Some reports suggest that extraintestinal diseases are related to H. pylori infections. Some studies have shown strong associations between vitamin B12 and H. pylori infections. This study aims to investigate H. pylori infections in patients with neurological symptoms of vitamin B12 deficiency. Methods: The data of patients with Vitamin B12 deficiency who were admitted to neurology and gastroenterology outpatient clinics were scanned. The main inclusion criterion for the patients was having no other clinical conditions that account for the neurological symptoms. To evaluate the relationship with neurological symptoms, the patients were divided into two groups: Group I: H. pylori (+); and Group II: H. pylori (-). Results: Of the 40 patients included the study, H. plyori infection was seen in 27 (68%) patients. The most frequent neurological diseases were major depression + mild cognitive impairment (14.8%), and tension-type headache + major depression (25.9%) in patients with H. pylori infection. None of the patients showed hematological changes typical of megaloblastic anemia signs in CBC. Conclusions: We conclude that neuropsychiatric disorders due to Vitamin B12 deficiency may occur in the absence of anemia or an elevated MCV and it is frequently seen together with H. pylori infection.